Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.
Republic of Korea ; Spine ; Wounds, Gunshot

BACKGROUND: The aim of this study was to elucidate the relationship of environmental tobacco smoke (ETS) exposure and the urine cotinine concentrations in Korean adolescents. METHODS: The study population was 1st grade high school adolescents (n = 1467, girls 22.2%) recruited from four high schools, two from Seoul, one from Kangleung and one from Woolsan. We obtained information on active smoking and ETS exposure through self-reported questionnaire and urine cotinine concentrations. RESULTS: The prevalence of active smoking was 6.9% in boys and 0.9% in girls. Median urine cotinine concentrations were 19.5 microgram/L (range, 0-2341 microgram/L) among smokers, and 0 microgram/L (range, 0-1359 microgram/L) among nonsmokers. The positive rate of urine cotinine among nonsmokers exposed to ETS was 2.9%. Boys were exposed to ETS in the order of frequency in PC room (79.6%), home (39.4%), school (11.5%), and public places (5.9%); girls were exposed in the order of frequency in home (40.9%), PC room (33.2%), public places (28.0%), and school (15.2%). The frequency and duration of ETS exposure were significantly larger and longer in boys than in girls. Boys contacted friends who smoked more than girls did (32.6% vs. 17.1%). Parents; smoking status was similar both in boys and girls. Any information on ETS exposure did not differ according to the detectable urine cotinine among nonsmoking adolescents. CONCLUSION: Low positive rate of urine cotinine and no association of urine cotinine with various ETS exposure history reflect that urine cotinine may not be a good marker for ETS exposure in Korean adolescents.
Adolescent ; Cotinine ; Friends ; Humans ; Prevalence ; Smoke ; Smoking ; Tobacco ; Surveys and Questionnaires

BACKGROUND: The worldwide prevalence of obesity and allergic diseases has increased. We aimed to explore the relation of overweight to asthma, atopic dermatitis, allergic rhinitis and conjunctivitis in a sample of Korean adolescents. METHODS: We investigated the prevalence of symptoms of asthma and other allergic diseases by using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The survey was conducted among 1,499 high school students in 3 regions of Korea. RESULTS: The lifetime prevalence of wheezing (21.2% vs. 15.7%, P = 0.04), the 12 months-prevalence of wheezing (4.5% vs. 2.0%, P = 0.04), exercise induced wheezing (13.8% vs. 9.3%, P = 0.04), treatment of asthma (3.3% vs. 1.1%, P = 0.01) and the prevalence of symptoms of allergic rhinitis (11.0% vs. 5.1%, P = 0.001) were signifi cantly higher in overweight boys than normal weight boys, but not in girls. However, there were no signifi cant differences of the prevalence of symptoms and past history of atopic dermatitis and allergic conjunctivitis between overweight and normal weight groups. In boys, overweight increased the risk of the lifetime prevalence of wheezing (OR 1.54, 95% CI: 1.05-2.24) and 12 months-prevalence of exercise induced wheezing (OR 1.64, 95% CI: 1.05-2.55) after adjusting for confounding variables. CONCLUSION: Overweight could be a risk factor for the development of symptoms of asthma and allergic rhinitis in adolescent boys, whereas it was not a signifi cant risk factor for allergic diseases in girls.
Adolescent ; Asthma ; Confounding Factors (Epidemiology) ; Conjunctivitis ; Conjunctivitis, Allergic ; Dermatitis, Atopic ; Humans ; Hypersensitivity ; Korea ; Obesity ; Overweight ; Prevalence ; Respiratory Sounds ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors

Finite Element Analysis ; Models, Theoretical ; Tooth

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.
Adult ; Angioplasty, Balloon ; Anthracyclines ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Doxorubicin* ; Drug Therapy* ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Heparin ; Humans ; Hypokinesia ; Lymphoma, Non-Hodgkin* ; Myocardial Infarction* ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Stents

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.
Adult ; Angioplasty, Balloon ; Anthracyclines ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Doxorubicin* ; Drug Therapy* ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Heparin ; Humans ; Hypokinesia ; Lymphoma, Non-Hodgkin* ; Myocardial Infarction* ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Stents

Anomalies of the lumbosacral nerve roots, in which conjoined nerve roots are most common, are occasionally accompanied by herniated nucleus pulposus. Most of these anomalies were incidental findings from operations, and recent advances in diagnostic imaging techniques have increased the number of cases of lumbosacral root anomalies reported. All these anomalies are congenital, unilateral and almost exclusively situated at the L5-S1 segment. Diagnostic techniques, such as myelography, CT and MRI detect conjoined nerve root. Conjoined nerve root may be confused with a dumbbell tumor or extruded free disc fragment on CT scans. Surrounded by high-signal intensity epidural fat, a conjoined nerve root is more clearly depicted on MR images than on CT scans. Although the size of disc herniation was small, the symptom was magnified by a relatively fixed conjoined root. At surgery, it is necessary for a larger surgical exposure by means of hemi-laminectomy because of the fixation of the nerve roots, and difficulty in retraction. Recently, we experienced two cases of conjoined nerve root and presented them with a review of the literature.
Diagnostic Imaging ; Incidental Findings ; Magnetic Resonance Imaging ; Myelography ; Tomography, X-Ray Computed

Intraarticular ganglion of the knee joint is a cystic mass found around cruciate ligaments in infrapatellar fat pad or under patellar tendon. The first report on intraarticular ganglion of the knee joint along with some intermittent case reports or ganglion around the cruciate ligaments were in 1924 by Caan. Ganglion under the patellar tendon or in the patellar fat pad was first reported in 1972 by Muckle and Monahan. The two cases were treated with open arthotomy and mass excision. There was been no report on ganglion under patellar tendon since then. We managed two cases of ganglion under the patellar tendon with arthroscopic debridement. After 16 months of treatment, there has no recurrence of symptom. We report two cases of ganglion under patellar tendon with the review of the literature.
Adipose Tissue ; Debridement ; Ganglion Cysts* ; Knee Joint ; Ligaments ; Patellar Ligament* ; Recurrence

Twenty five consecutive patients requiring reoperation due to hemorrhage following surgery for intracranial hematoma removal were identified in a retrospective review of 211 cases of traumatic intracranial lesions treated at our hospital between January 1990 and December 1994. In cases involving head injury, reoperation is nowadays not uncommon. The incidence of cases requiring reoperation was 11.8%, while delayed or recurrent lesions were more common among older patients(mean age=44.39 years). Acute subdural hemorrhage was the most common initial lesion requiring reoperation: in intracerebral and acute subdural hemorrhage, the incidence of reoperation was relatively high(23.1% and 14.7%, respectively): acute epidural hemorrhage was next most common(8.8%). In 88.0% of cases, reoperation was performed within 24 hours. At the time of discharge, good recovery was reported in five cases(20.0%), moderate disability in ten(40.0%), severe disability in two(8.0%), vegetative state in two(8.0%) and death in six(24.0%). The outcome seems to be related to lesions requiring reoperation rather than initial lesions. Furthermore, closed observation and aggressive management can rapidly improve the outcome, even in patients requiring reoperation: it is, in addition, of the utmost importance that CT scans be used early and repeatedly, especially in patients who are at risk of delayed or recurrent lesions.
Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhage, Traumatic* ; Intracranial Hemorrhages* ; Persistent Vegetative State ; Postoperative Hemorrhage ; Reoperation* ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: Both benign prostate hyperplasia(BPH) and male pattern baldness (androgenic alopecia) share the pathogenesis of androgen dependent disorder in addition to afflict large population of old men with chronobiological progress. However, it is unclear that both diseases relate to each other on epidemiologic basis. We evaluated the frequency and severity of male pattern baldness between the patients with BPH and control group. MATERIALS AND METHODS: A total of 225 patients with BPH(mean age: 69.3+/-6.5years) and 160 controls(mean age: 68.5+/-6.4 years), whose age over 60, was included in this study. The estimation of bladness severity was based on the Norwood's classification(grade 1 to VII). International prostate symptom score (IPSS) and genetic tendency of baldness were also evaluated. The difference of IPSS and grade of baldness between two groups were analysed by Mann-whitney test and the frequency of inherited baldness were compared by Chisquare test. Correlations between severity of baldness and IPSS of each group were estimated by Spearman's rank correlation method. RESULTS: It was noted that the patients with BPH had an apparent higher grade of male pattern baldness in comparison with that of controls(median value of IV to 111, p<0.001). The proportion of male pattern baldness with grade IV or greater in BPH group was significantly larger than that of controls(53.8% versus 36.9%, p<0.01). There was greater frequency of inheritant baldness in BPH group than in controls(31.6% versus 12.5%, p<0.001). No significant correlations were noted between baldness severity and IPSS in both groups. CONCLUSIONS: Our study demonstrated there was a strong association of BPH with male pattern baldness.
Alopecia* ; Humans ; Hyperplasia* ; Male* ; Prostate*